阴茎头静脉畸形 ：分型及其长脉宽 1 064 nm 激光治疗

摘要/Abstract

摘要：

　目的　建立阴茎头静脉畸形（Venous malformation of glans penis，GPVM）的分型体系，评价长脉宽 1 064 nm

Nd : YAG（LP-Nd : YAG）激光治疗阴茎头静脉畸形的疗效和安全性。方法　2013 年 8 月至 2018 年 2 月，纳入在本

中心诊疗的 GPVM 患者 26 例。根据受累面积和勃起功能分为孤立型（Ⅰ型）、泛发型（Ⅱ型）和全阴茎头型（Ⅲ型），

其中Ⅲ型又分为无勃起功能障碍（Ⅲ a 型）和有勃起功能障碍（Ⅲ b 型）。本组中 25 例采用 LP-Nd : YAG 激光治疗，

并将治疗结果分为 5 个等级。于每次治疗后记录严重和轻微不良反应。结果　26 例患者中有 1 例成年患者放弃治疗，

另 1 例未成年患者中止治疗，其余 24 例患者完成 LP-Nd : YAG 激光治疗。平均（2.4±1.1）次治疗后，4 例（16.7%）

患者达到“优（清除率 75%~90%）”，20 例（83.3%）患者达到“近治愈（清除率 >90%）”。24 例患者治疗后随访

6~14 个月，平均（9.0±2.6）个月，均无复发。轻微并发症：黏膜质地改变 8 例、暂时性色素沉着 4 例、水泡及薄

痂 2 例、暂时性纤维结节 2 例、暂时性色素减退 1 例、浅表瘢痕 1 例、轻度感觉减退 1 例；严重并发症：组织缺损

及局部凹陷 1 例、不消退纤维结节 2 例。结论　LP- Nd : YAG 激光治疗对 GPVM 清除率较高，安全性良好。本分型

方法在一定程度上能够预测激光治疗的疗效和安全性，不同类型的 GPVM 可能出现不同的不良反应。

关键词:

静脉畸形, 　阴茎头, 　长脉宽 Nd : YAG 激光

Abstract:

Objective　To propose a classification system for venous malformations of glans penis (GPVM) and evaluate the efficacy and safety of long-pulse 1 064 nm Nd : YAG (LP-Nd:YAG) laser therapy for GPVM. Methods　Twenty-six patients with GPVM were included in this study. They were classified into three types according to involved area and erectile function: Solitary type (Type Ⅰ ), extensive type (Type Ⅱ ), and full glans penis type without (Type Ⅲ a) or with (Type Ⅲ b) erectile dysfunction. Twenty-five of them were treated by LP-Nd : YAG laser, and the outcomes were converted into a five grading scales. The major and minor complications were recorded after each session. Results　Twenty-four patients completed LP-Nd : YAG laser treatment. Four patients (16.7%) achieved“excellent (clear rate 75%-90%)” results and 20 patients (83.3%) achieved “nearly cured (clear rate>90%)” after an average of 2.4±1.1 sessions (1-5 sessions) of treatment. All treated patients were followed up for 6-14 months [average (9.0±2.6) months], and no recurrence was observed. The minor complications included mucosa texture change (n=8), temporary hyperpigmentation (n=4), blister and thin scab (n=2), temporary fibrous nodules (n=2), temporary hypopigmentation (n=1), superficial scar (n=1), slight hypoesthesia (n=1). And the minor complications included tissue defect and local depression (n=1) and permanent fibrous nodules (n=2). Conclusion　LP-Nd : YAG laser has rather high clearance rate of GPVM and major complications are rare. This classification system is valuable to predict outcomes and safety of laser therapy to a certain degree. Different type of GPVM is likely to be related to different complications.

Key words:

　Venous malformation, 　Glans penis, 　Long-pulse Nd : YAG laser

段琼, 胡丽, 林晓曦, 等.

阴茎头静脉畸形：分型及其长脉宽 1 064 nm 激光治疗

[J]. 组织工程与重建外科杂志, 2023, 19(6): 535-.

DUAN Qiong, HU Li, LIN Xiaoxi, et al. Venous malformation of glans penis: Classification and long-pluse 1 064 nm Nd:YAG laser therapy[J]. Journal of Tissue Engineering and Reconstructive Surgery, 2023, 19(6): 535-.